| NPI | 1013063627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX N3181) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1957) |
| 207R00000X Internal Medicine (Licence: TX N3181) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2012-08-17 |