| NPI | 1659436004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N2390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002612) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2017-02-24 |