| NPI | 1053361915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 21907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 34294) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IA 34294) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: IA 34294) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-12-19 |