| NPI | 1376002642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: GA 98081) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 98081) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2024-02-21 |