| NPI | 1245468768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: VA 010249008) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101249008) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-11-23 |