| NPI | 1194778878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 87599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M0735) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 87599) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD447980) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-04-13 |