| NPI | 1023306040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2016015321) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2011018542) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2020-10-26 |