| NPI | 1871020156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 292980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 23138) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MA 292980) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NH 23138) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-11-08 |