| NPI | 1740537257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q2156) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 1624) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2022-09-02 |