| NPI | 1518999275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 973433871205) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 343387-1205) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-08-02 |