| NPI | 1649251778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MA 47715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 47715) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: DC MD038893) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MA 47715) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: DC MD038893) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2021-09-07 |