| NPI | 1710390786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T1803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT207004) |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2024-03-22 |