NPI | 1508244799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R9805) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 72282) |
Enumeration Date | 2015-05-08 |
Last Update Date | 2020-10-08 |