| NPI | 1376837823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 18702) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P9191) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2019-04-03 |