| NPI | 1417390543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.35234) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2286) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2020-01-19 |