| NPI | 1659723484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 74889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267868) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2025-01-09 |