| NPI | 1306228150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S10014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01079845A) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2019-02-22 |