| NPI | 1154311496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX K6732) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K6732) |
| 207R00000X Internal Medicine (Licence: TX K6732) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-03-25 |