| NPI | 1891765608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: MI 4301045334) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301045334) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-10-22 |