| NPI | 1497744783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX L3086) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MT MED-PHYS-LIC-26259) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: UT 8490057-1205) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: ND 12169) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2017-09-19 |