| NPI | 1326200874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P0994) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 249148) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-04-05 |