| NPI | 1336354331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N-7886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.117277) |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2023-04-17 |