| NPI | 1639399363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 54391-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36116572) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MS 20276) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2011-09-09 |