| NPI | 1043388325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 8710970-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD425307) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD425307) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2022-09-29 |