| NPI | 1932635851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S4368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10060879) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-06-30 |