NPI | 1508206095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S4431) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 302339) |
207R00000X Internal Medicine (Licence: VA 0102204149) | |
Enumeration Date | 2013-06-27 |
Last Update Date | 2022-08-10 |