| NPI | 1558686774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 35.126058) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2010-03-30 | 
| Last Update Date | 2015-06-15 |