| NPI | 1700087210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q5716) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087141) |
| 207R00000X Internal Medicine (Licence: WV 29934) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2024-05-15 |