| NPI | 1861004913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: TX V7660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT219749) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2025-08-03 |