| NPI | 1194779348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX d9479) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX D9479) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX D9479) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-08 |