| NPI | 1083835433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: CA G55876) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G55876) |
| 207RR0500X Internal Medicine Rheumatology (Licence: CA G55876) | |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: CA G55876) | |
| 207R00000X Internal Medicine (Licence: CA G55876) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |