| NPI | 1093042095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 201801251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101256953) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 201801251) | |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2023-12-05 |