| NPI | 1689615601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PA MD027186E) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NJ MA51321) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-02-01 |