| NPI | 1336310333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N5292) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 38034) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2012-06-08 |