| NPI | 1225229362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4872) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MN 103752) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2025-07-22 |