| NPI | 1659374882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: SC 14896) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 14896) |
| 174400000X Specialist (Licence: NC 39768) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2013-12-17 |