| NPI | 1679883771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME138446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 45711) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME138446) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2023-06-21 |