| NPI | 1982994836 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CT 71698) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 276522) | 
| Enumeration Date | 2011-04-12 | 
| Last Update Date | 2022-08-04 |