| NPI | 1073534434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 154722) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2021-03-25 |