| NPI | 1255441424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TX H1337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H1337) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2011-10-26 |