| NPI | 1467614008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P4342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 70791) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2013-08-16 |