| NPI | 1114135092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101243815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 19749) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-05-26 |