| NPI | 1568568582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A84479) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: CA A84479) |
| 207Q00000X Family Medicine (Licence: AZ 48490) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2018-09-18 |