| NPI | 1619505617 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 69693) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30868) | 
| 207R00000X Internal Medicine (Licence: MN 69693) | |
| Enumeration Date | 2020-03-27 | 
| Last Update Date | 2025-07-01 |