| NPI | 1669812442 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD61059942)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9853)  | 
| 207R00000X Internal Medicine (Licence: IA Md-43279)  | |
| Enumeration Date | 2013-06-26 | 
| Last Update Date | 2020-09-10 |