| NPI | 1710281027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P0093) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 003718-1) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2024-08-19 |