| NPI | 1295706273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T6010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46071) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-04-30 |