| NPI | 1003511445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: VA 0102210183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL89715) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-06-24 |