| NPI | 1588717680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OR MD10173) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OR MD10173) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-08-12 |