| NPI | 1710995568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R4546) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX R4546) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 103448) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2026-01-27 |