| NPI | 1922347400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R4859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME127671) |
| 207R00000X Internal Medicine (Licence: IN 01081549A) | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2022-10-11 |