| NPI | 1467542175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C142559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 48006) |
| 207R00000X Internal Medicine (Licence: TX N6851) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-11-01 |