| NPI | 1467791160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U1487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.206215) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2023-06-20 |