| NPI | 1346557279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P5674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 319975) |
| 207R00000X Internal Medicine (Licence: MO 2019024436) | |
| 207R00000X Internal Medicine (Licence: AR E-12419) | |
| 207R00000X Internal Medicine (Licence: FL ME142168) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2019-10-30 |