| NPI | 1750351219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E9772) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX E-9772) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX E9772) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2017-03-09 |