| NPI | 1962538439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M9256) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OK 24943) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-01-14 |