| NPI | 1295997930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 249216) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2016-08-19 |