| NPI | 1255588208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q4290) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q4290) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX Q4290) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2019-04-30 |