| NPI | 1457585739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N5991) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 20974) |
| 207R00000X Internal Medicine (Licence: LA MD.202977) | |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2023-04-03 |