NPI | 1124005038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY 38463) |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: TN 38325) |
Enumeration Date | 2005-12-30 |
Last Update Date | 2018-05-01 |