| NPI | 1194785923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4785) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 32370) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-07-31 |