| NPI | 1295093995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 9404247-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9404247-1205) |
| 207R00000X Internal Medicine (Licence: IL 125062122) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2026-08-05 |