| NPI | 1508285099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MA 272754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 65449) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2022-07-21 |