| NPI | 1326377243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P0251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.096783) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2016-03-01 |