| NPI | 1427058338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX G3405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR R3602) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2007-07-14 |