| NPI | 1881791978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L9973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM A138506) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-06-18 |