| NPI | 1811904592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC SC7456) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: SC SC7456) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2010-08-08 |