| NPI | 1851509939 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME99059) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: FL TRN 9489) | 
| Enumeration Date | 2007-05-20 | 
| Last Update Date | 2009-01-27 |