| NPI | 1851633424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 277495) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NJ 25MA11635500) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2024-06-17 |