| NPI | 1619976917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CT 014693) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: CT 014693) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2011-10-17 |