| NPI | 1891846077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD00024518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00024518) |
| 173000000X Legal Medicine (Licence: WA MD00024518) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2026-06-30 |