NPI | 1134186331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U7830) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 17122) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 17122) | |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX U7830) | |
Enumeration Date | 2006-05-01 |
Last Update Date | 2024-11-21 |