| NPI | 1598927006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N6956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10031187) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2013-03-27 |