| NPI | 1881631596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q5363) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD08649) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-10-04 |