| NPI | 1386006294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T2911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 312834) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-03-18 |