| NPI | 1073848396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX p1572) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10034505) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2021-05-25 |