| NPI | 1447568597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U7131) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 79222) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2024-05-15 |