| NPI | 1649703125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22142) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S6587) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2022-09-14 |