| NPI | 1073596441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E7263) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX E7263) |
| 207R00000X Internal Medicine (Licence: TX E7263) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: TX E7263) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2014-07-10 |