| NPI | 1316918782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E5979) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX E5979) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-08-29 |