| NPI | 1750924205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MD D0102011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.145975) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2025-12-11 |