| NPI | 1477604817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MO R1J62) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: KS 04-26764) | 
| Enumeration Date | 2007-01-14 | 
| Last Update Date | 2021-03-22 |