| NPI | 1316458862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: UT 10556897-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10556897-1206) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2019-12-04 |