| NPI | 1225528466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A174153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10064981) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-02-25 |