| NPI | 1023264298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N2780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 136829) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2020-10-14 |