| NPI | 1457635559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01071762A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2120) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2022-10-20 |