| NPI | 1043630502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NC 2023-03036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101275460) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: KY TP276) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: VA 0101275460) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: PA MD466766) | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-10-16 |