| NPI | 1760450647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E9206) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX E9206) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX E9206) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-08-30 |