| NPI | 1174753172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CT 047978) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX Q6526) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2023-05-10 |