| NPI | 1699160465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 10097486-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 10097486-1205) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-10-28 |