| NPI | 1619071719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX L2338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L2338) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX L2338) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2022-02-24 |