| NPI | 1194751214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K1633) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX K1633) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-07-09 |