| NPI | 1679768089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N1011) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX N1011) |
| Enumeration Date | 2007-09-09 |
| Last Update Date | 2015-02-24 |