| NPI | 1831205053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P8301) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08037200) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P8301) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-06-16 |