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 |