| NPI | 1104965102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 2004-0423) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: NM MD2008-0732) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-03-01 |