| NPI | 1992984272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M2609) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 72553) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2010-01-13 |