| NPI | 1366499220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301081763) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-09-30 |