| NPI | 1740341072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036115961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 6258) |
| 207R00000X Internal Medicine (Licence: TX N8682) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-12-17 |