| NPI | 1134539562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A153986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10049990) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-05-25 |