| NPI | 1124215033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD60010629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M6711) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2012-05-07 |