| NPI | 1578883377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P6489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 47523) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX P6489) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2016-12-14 |