| NPI | 1760481048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD00047633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00047633) |
| 207R00000X Internal Medicine (Licence: ND 9748) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2011-01-26 |