| NPI | 1912261025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD60848565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 141152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2018-05-31 |