| NPI | 1578577177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A56147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M7545) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-11-16 |