| NPI | 1043650765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MI 4301103154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027945) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2025-11-28 |