| NPI | 1578547493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 36763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 02773) |
| 207RR0500X Internal Medicine Rheumatology (Licence: IA 02773) | |
| 207RR0500X Internal Medicine Rheumatology (Licence: WI 36763) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2021-08-23 |