| NPI | 1568437432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L8829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036106030) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2015-12-09 |