| NPI | 1164717740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: CA A171534) |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: VA 0101252306) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2024-05-22 |