| NPI | 1336526052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KS 0442769) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2023018866) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2024-10-09 |