| NPI | 1225229362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4872) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 103752) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2015-11-25 |