| NPI | 1730117615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NE 17486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 17486) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2015-09-09 |