| NPI | 1346521218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2014-0640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10041385) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2014-08-27 |