| NPI | 1083660351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME126126) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 36980) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD432714) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 324056) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2025-07-09 |