| NPI | 1871972067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NE 37273) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 302123) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: KY 58816) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2026-02-27 |