| NPI | 1093956476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N6061) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 27483) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2021-08-30 |