| NPI | 1538415526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MA 269676) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME122987) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2019-08-26 |