| NPI | 1932442860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U2995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD457492) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2024-06-19 |