| NPI | 1366838948 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: LA 303026) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 303026) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-10 | 
| Last Update Date | 2018-08-09 |