| NPI | 1295739126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L4331) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OK 29405) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MS 19565) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2021-09-30 |