| NPI | 1306892005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E1595) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX E1595) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX E1595) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-04-12 |