| NPI | 1508864984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME 122209) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 109694) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2014-12-01 |