| NPI | 1932307766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N6537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9406784) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2014-01-02 |