| NPI | 1700033883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T7035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D71972) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2026-02-23 |