| NPI | 1083691083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 28450) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 28450) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2019-01-16 |