| NPI | 1275852717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q2629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG151493) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2022-06-09 |