| NPI | 1033220603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 181318-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 181318-1205) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: UT 181318-1205) | |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: UT 181318-1205) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-10-15 |