| NPI | 1982658902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY KY 37360) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WV WV 20928) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-03-01 |