| NPI | 1457582108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 57674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P24004) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2025017646) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2025-10-20 |