| NPI | 1245437425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N6199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10028165) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-06-16 |