| NPI | 1699538132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS T-5745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10097971) |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2026-04-22 |