NPI | 1114361508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S3993) |
Additional Taxonomies | 282N00000X General Acute Care Hospital |
Enumeration Date | 2013-04-29 |
Last Update Date | 2023-11-08 |