| NPI | 1336343706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N7374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085759) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2024-12-02 |