| NPI | 1669649596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N7046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 252617) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2023-05-23 |