| NPI | 1902813413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 21406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K6667) |
| 207R00000X Internal Medicine (Licence: IN 01048083A) | |
| 207R00000X Internal Medicine (Licence: FL ME75686) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-07-24 |