| NPI | 1528314721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q3516) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10044198) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2016-06-17 |