| NPI | 1518906569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX L0967) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 21523) | 
| 207R00000X Internal Medicine (Licence: TX L0967) | |
| Enumeration Date | 2006-06-05 | 
| Last Update Date | 2016-06-24 |