| NPI | 1952333262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L4933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD447278) |
| 207R00000X Internal Medicine (Licence: NJ 25MA09197200) | |
| 207R00000X Internal Medicine (Licence: SC MD 35163) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-04-22 |