| NPI | 1952787848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: FL OS21502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS21502) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: FL OS21502) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2025-03-28 |