| NPI | 1427040815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L9431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L-9431) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2011-01-18 |