| NPI | 1598780694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A053527) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J3386) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-10-13 |