| NPI | 1205927829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H6568) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX H6568) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H6568) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX H6568) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-11-15 |