| NPI | 1902069230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S1996) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX S1996) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX S1996) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2023-08-22 |