| NPI | 1619311305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NC 2017-01147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-01147) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2022-05-02 |