NPI | 1013303734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61122148) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R4628) |
Enumeration Date | 2015-04-09 |
Last Update Date | 2022-01-18 |