| NPI | 1629072285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX G2453) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX G2453) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2015-09-16 |