| NPI | 1952366684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P8236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 17980) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-06-11 |