| NPI | 1023247111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: FL ME129210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-015870) |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: AL MD.32957) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2022-01-04 |