| NPI | 1952787848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: OH 34.014923) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.014923) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: OH 34.014923) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2021-08-17 |