| NPI | 1366710121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD020659E) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: PA md020659e) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |