| NPI | 1831487719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX T2767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2011010481) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MO 201600761) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2021-11-13 |