| NPI | 1205185477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 159397) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q0672) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2024-06-04 |