| NPI | 1922236660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q3247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD156807) |
| 207R00000X Internal Medicine (Licence: MI 4301094980) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-02-20 |