| NPI | 1447441639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N7140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0028949) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2013-10-30 |