| NPI | 1447613468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U5543) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL DO.1796) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-10-12 |