| NPI | 1184613754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PR 6079) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 6079) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2013-08-15 |