| NPI | 1669637195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q7528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 049916) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2016-08-24 |