| NPI | 1114554276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OK 45689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 328033) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-06-01 |