| NPI | 1235302548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P3955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01070095A) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2019-10-02 |