| NPI | 1063030690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD61406728) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61406728) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2025-06-10 |