| NPI | 1356410104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S8382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2006-0679) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-10-09 |