| NPI | 1053607507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q6226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10041519) |
| 207R00000X Internal Medicine (Licence: MN 59178) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2024-03-11 |