| NPI | 1770710717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T4021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 46444) |
| 207R00000X Internal Medicine (Licence: AZ R71505) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2024-02-14 |