| NPI | 1922263375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P1384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301091957) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2013-01-10 |