| NPI | 1033321799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P5828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 40137) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2021-09-02 |