| NPI | 1992268999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T7036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 41347) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-03-25 |