| NPI | 1679915268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PA OS007713-L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA AG2079689) |
| 207K00000X Allergy & Immunology (Licence: PA OS007713-L) | |
| 208U00000X Clinical Pharmacology (Licence: PA OS007713-L) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |