| NPI | 1023109923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CO 25100) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WY 3714A) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NE 21258) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-02-07 |