| NPI | 1174632970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CA A107051) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML20008603) | 
| 207R00000X Internal Medicine (Licence: CA A107051) | |
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2012-10-02 |