| NPI | 1962491191 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX L3825)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: TX L3825)  | 
| Enumeration Date | 2005-10-20 | 
| Last Update Date | 2013-02-06 |