| NPI | 1538265905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX l2859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L 2859) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-05-29 |