| NPI | 1447410444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 7845732-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 148076) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2011-07-18 |