| NPI | 1619395068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 65241) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 65241) |
| 207R00000X Internal Medicine (Licence: PA OT018163) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2021-09-22 |