| NPI | 1154945087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U4359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 714063) |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2023-06-15 |