| NPI | 1720087414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: TX H1610) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H1610) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2025-01-31 |