| NPI | 1417062563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R9162) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MO R9162) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-07-15 |