| NPI | 1275795593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 47663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10024963) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2014-04-10 |