| NPI | 1881038107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX BP10046658) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: DC MD045198) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-07-11 |