| NPI | 1811428964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: KY 56690) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.151848) |
| 207R00000X Internal Medicine (Licence: IL 125.070055) | |
| 207RR0500X Internal Medicine Rheumatology (Licence: IL 036.151848) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-11-21 |