| NPI | 1063874881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 69257) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH 3405) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-08-03 |