| NPI | 1386618874 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 20389)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 17329)  | 
| Enumeration Date | 2006-02-14 | 
| Last Update Date | 2015-08-11 |