| NPI | 1104051382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P2447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BPI 0035392) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2022-06-10 |