| NPI | 1003101783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q0558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-248296) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2024-04-30 |