| NPI | 1407888613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 81-286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX F9108) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NM 81-286) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: NM 81-286) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-06-19 |