| NPI | 1114015138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX H6679) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H6679) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-03-03 |