| NPI | 1073792438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P9460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044968) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2017-02-01 |