| NPI | 1629092614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX L7291) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX L7291) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2026-02-07 |