| NPI | 1538438858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S3647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 268560) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2020-10-23 |