| NPI | 1053369280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX M4524) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01053985A) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2010-11-18 |