| NPI | 1740402874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M9444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A97378) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-02-21 |