| NPI | 1932154291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A105575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L1675) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-12-10 |