| NPI | 1891926572 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX Q4259)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2009010522)  | 
| 207R00000X Internal Medicine (Licence: TX Q4259)  | |
| 207R00000X Internal Medicine (Licence: WV 24866)  | |
| 207R00000X Internal Medicine (Licence: KY 48070)  | |
| 207R00000X Internal Medicine (Licence: TN MD0000051589)  | |
| Enumeration Date | 2009-07-29 | 
| Last Update Date | 2025-04-24 |