| NPI | 1144222159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H6858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 6858) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX H6858) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2024-09-16 |