| NPI | 1396733796 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: GA 045683) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 045683) | 
| Enumeration Date | 2005-10-10 | 
| Last Update Date | 2012-09-07 |