| NPI | 1467806810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R8930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056504) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2022-05-12 |