| NPI | 1619125515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q0582) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18077) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2023-03-13 |