NPI | 1588895957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q2913) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194297) |
Enumeration Date | 2009-08-04 |
Last Update Date | 2023-03-13 |