| NPI | 1699806133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G77386) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L3781) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-12-26 |