| NPI | 1275892002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 30831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2674) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2018-08-29 |