NPI | 1760766356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: FL ME122420) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 36724) |
207R00000X Internal Medicine (Licence: OH 57019626) | |
207R00000X Internal Medicine (Licence: FL ME122420) | |
Enumeration Date | 2011-10-01 |
Last Update Date | 2021-08-09 |