| NPI | 1699064766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX R3247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R3247) |
| 207R00000X Internal Medicine (Licence: CA 141191) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2026-02-25 |