| NPI | 1114935418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX K0997) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: UT 11711039-1205) | 
| Enumeration Date | 2006-08-03 | 
| Last Update Date | 2020-05-20 |