| NPI | 1962638858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX P2857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX p2857) |
| 207R00000X Internal Medicine (Licence: TX BP1-0034935) | |
| 207R00000X Internal Medicine (Licence: TX FG3337765) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: CA 20A12691) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX FG3337765) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2019-12-23 |