| NPI | 1750902607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2023-1009) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NM MD2023-1009) |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2025-08-18 |