| NPI | 1467713800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A122704) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q3498) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2023-01-13 |