| NPI | 1902911878 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: ID O-1470)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: GA 043709)  | 
| Enumeration Date | 2006-08-20 | 
| Last Update Date | 2021-02-15 |