| NPI | 1144274341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L2436) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX L2436) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN 44245) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-11-02 |