| NPI | 1669737862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY 48350) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: SD 10263) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2023-02-06 |