| NPI | 1841496783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P1236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.126383) |
| 207R00000X Internal Medicine (Licence: MO 2005013988) | |
| 207R00000X Internal Medicine (Licence: AZ 52452) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2022-04-25 |