| NPI | 1780604793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: TX F1464) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX F1464) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2009-05-07 |