| NPI | 1528077112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M9928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E2554) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2009-05-26 |