| NPI | 1205367125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: VA 0101276199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 73155) |
| 207R00000X Internal Medicine (Licence: VA 0101276199) | |
| 208M00000X Hospitalist (Licence: WI 73155) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2022-09-28 |