| NPI | 1528037355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M5451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 14979) |
| 207R00000X Internal Medicine (Licence: TX m5451) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX M5451) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2014-07-10 |