| NPI | 1134564974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NH 18654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455465) |
| 207R00000X Internal Medicine (Licence: NH 18654) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2024-05-01 |