NPI | 1083746168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P3254) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 16054) |
207R00000X Internal Medicine (Licence: LA 12732R) | |
Enumeration Date | 2007-03-12 |
Last Update Date | 2023-03-07 |