| NPI | 1568447563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX M7946) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME52995) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2012-10-03 |