| NPI | 1912463902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-907) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: AR PA-907) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2021-09-10 |