| NPI | 1104269265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 1015064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 63353-20) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OR MD190317) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2023-03-21 |