| NPI | 1134106438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 27945) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 27945) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-06-11 |