| NPI | 1275774937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: AZ 44910) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R70588) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2014-07-07 |