| NPI | 1063702876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q0485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD23168) |
| 207R00000X Internal Medicine (Licence: TX BP10039985) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2023-10-31 |