| NPI | 1144633504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD.60736115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 55499) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-08-12 |