| NPI | 1528328531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A135902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043178) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2018-07-09 |