| NPI | 1730529918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: FL ME153669) |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: NM MD2016-0885) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2022-05-02 |