| NPI | 1972781821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U2726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 42799) |
| Enumeration Date | 2008-02-02 |
| Last Update Date | 2023-08-25 |