| NPI | 1770522633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2000160315) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: TX M7820) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-02-14 |