| NPI | 1104147453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CO Dr.0058799) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: PA OS017698) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2017-08-08 |