| NPI | 1326458746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.42145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R3817) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2021-01-28 |