| NPI | 1396369021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2021045485) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: MO 2021045485) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-09-23 |