| NPI | 1205871035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2008017232) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2010-00595) |
| 207R00000X Internal Medicine (Licence: NY 252911-1) | |
| 207R00000X Internal Medicine (Licence: NC 2010-00595) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2026-08-11 |