| NPI | 1396300380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD.MD.61417913) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 261964) |
| Enumeration Date | 2019-05-05 |
| Last Update Date | 2023-06-03 |