| NPI | 1932393931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2008-0537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N0870) |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2014-08-19 |