| NPI | 1659682284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 22696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q0531) |
| 207R00000X Internal Medicine (Licence: GA 98354) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2024-02-29 |