| NPI | 1477978773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101024919) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: PA OS022371) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MI 5101024919) | |
| Enumeration Date | 2014-02-23 |
| Last Update Date | 2024-04-17 |