| NPI | 1447545819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q9140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198611) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2016-10-26 |