| NPI | 1992016919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q5094) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 257897) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2019-09-03 |