| NPI | 1023058302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY 7100065040) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: KY 40119) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-09-13 |