| NPI | 1922501733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: ID O-1790) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.029999) |
| 207R00000X Internal Medicine (Licence: LA 327342) | |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2025-07-15 |