| NPI | 1215921978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 21078) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K8461) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2024-07-24 |