| NPI | 1104116391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 2016-01437) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2014-0485) |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2020-10-26 |