| NPI | 1518954767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 22161) |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: NC 22161) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2023-10-26 |