| NPI | 1346297660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S1480) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A90047) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-11-22 |