| NPI | 1144726902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T2570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10063392) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-12-07 |