NPI | 1295720746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S9886) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME126279) |
Enumeration Date | 2005-09-12 |
Last Update Date | 2021-03-31 |