| NPI | 1255362448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P4299) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A83496) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX P4299) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-01-25 |