| NPI | 1205004868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T7570) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.091629) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX T7570) | |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2023-06-29 |