| NPI | 1811300726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: SC 36982) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL36982) | 
| Enumeration Date | 2014-06-09 | 
| Last Update Date | 2024-09-09 |