| NPI | 1477788842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R8954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 36615) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2020-10-14 |