| NPI | 1467651711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: GA 70547) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: SC TL34875) | 
| 207R00000X Internal Medicine (Licence: FL ME 106894) | |
| 207R00000X Internal Medicine (Licence: SC LL29799) | |
| Enumeration Date | 2007-07-17 | 
| Last Update Date | 2025-07-14 |