| NPI | 1003947540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PR 16312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 16312) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PR 16312) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2010-10-15 |