| NPI | 1528046315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 200558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U5917) |
| 207R00000X Internal Medicine (Licence: AR E-16891) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: LA MD.200558) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-08-10 |