| NPI | 1093866170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD00036687) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: WA MD00036687) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-03-31 |