| NPI | 1144295023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H1379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H-1379) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-06-22 |