| NPI | 1659383503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CT 56383) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 151225) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: WI 1258) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-07-28 |