| NPI | 1114378676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 72111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10711) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CO DR.0062147) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2026-07-08 |