| NPI | 1457548133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CA A30592) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A30592) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2007-09-26 |