| NPI | 1588629323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L7497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 20020233) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2014-08-25 |