| NPI | 1417283714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX BP10034803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 40092) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2014-11-03 |