| NPI | 1275518912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K9869) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 118496) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 04-28125) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX K9869) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-08-22 |