| NPI | 1922042977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M4397) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A88338) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-03-02 |