| NPI | 1841269578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L3955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 023073) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2021-07-20 |