| NPI | 1972765808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KS 04-35035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407021) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2015-05-29 |