| NPI | 1629039938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K6843) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX k6843) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2022-07-20 |