| NPI | 1467710111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PA 002029) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: PA 002029) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |