| NPI | 1265634158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 35095543) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2005019385) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2015-07-21 |