| NPI | 1245383413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 9550226-8017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2007-0525) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2016-05-02 |