| NPI | 1902160336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX D8607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX D8607) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2012-07-02 |