| NPI | 1992474217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR 216352) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: AR 216352) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2022-09-07 |