| NPI | 1396155966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R3253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 309958) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2021-07-27 |