| NPI | 1225180680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P0382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A90442) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-04-26 |