| NPI | 1043304249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NH 13807) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D26704) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-05-01 |