| NPI | 1649236001 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G34995)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: CA G34995)  | 
| Enumeration Date | 2006-04-25 | 
| Last Update Date | 2014-06-13 |