| NPI | 1093199697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T0141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01080159A) |
| 207R00000X Internal Medicine (Licence: IL 125.066664) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-06-23 |