| NPI | 1669657896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: AL 11590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 11590) |
| 207R00000X Internal Medicine (Licence: AL 11590) | |
| 208000000X Pediatrics (Licence: AL 11590) | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2012-03-30 |