| NPI | 1366804551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A187216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S2165) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2024-11-14 |