| NPI | 1841498375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2016-0082) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N7144) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-07-21 |