| NPI | 1063420628 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MI 4301059096) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301059096) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2018-11-30 |