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 |