| NPI | 1588664486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX F1780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR R2990) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2007-07-14 |