| NPI | 1205195005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2015016131) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043107) |
| 207R00000X Internal Medicine (Licence: TX P9234) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2022-07-21 |