| NPI | 1386225761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD.MD.61529603) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078244) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2025-03-12 |