| 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 |