| NPI | 1306888219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 5758941-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 471563147) |
| 207R00000X Internal Medicine (Licence: CA AFE66682) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-11-18 |