| NPI | 1700268059 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R5943) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX R5943) | 
| Enumeration Date | 2015-06-23 | 
| Last Update Date | 2025-10-28 |