| NPI | 1801405147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 86178-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI CLP05107) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2025-08-05 |