| NPI | 1679633119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX N9854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N9854) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-01-02 |