| NPI | 1023253200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CT 049426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 049426) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: CT 049426) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2014-09-02 |