| NPI | 1780845883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N8780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10032358) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2016-07-14 |