| NPI | 1982745436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PR 13110) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: PR 13110) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2014-08-19 |