| NPI | 1326136292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX G2108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA00318) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-11-30 |