| NPI | 1902269855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 281575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 21565) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MA 281575) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NH 21565) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-11-08 |