| NPI | 1821389008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 35.126625) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 1821389008) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2020-05-07 |