| NPI | 1790771616 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CA G13441)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G13441)  | 
| Enumeration Date | 2005-09-26 | 
| Last Update Date | 2013-04-25 |