| NPI | 1225099104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N0558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME95288) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2024-05-23 |