| NPI | 1750520300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: AR E9290) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: VA 0116024267) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 236957) | |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2020-11-18 |