| NPI | 1609185818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q1841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 45676) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2021-03-31 |