| NPI | 1871888438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q4144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2017-0115) |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2023-10-03 |