| NPI | 1164685715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY TP865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.122220) |
| 208000000X Pediatrics (Licence: IL 036.122220) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2012-02-06 |