| NPI | 1225291784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P6665) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD443145) |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2018-07-11 |