| NPI | 1114111507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME119768) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 54119) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2014-07-24 |