| NPI | 1023236213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NE 25123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5030) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-03-07 |