| NPI | 1174572077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P6074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD035815) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2023-10-23 |