| NPI | 1568697993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 103318-1) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 16464-020) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2009-05-29 |