| NPI | 1740714062 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: PA OS021964) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017580) | 
| Enumeration Date | 2017-04-13 | 
| Last Update Date | 2022-07-22 |