| NPI | 1104262708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CA A132224) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A132224) | 
| Enumeration Date | 2013-05-22 | 
| Last Update Date | 2020-07-13 |