| NPI | 1144401720 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 48781) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 48781) | 
| Enumeration Date | 2007-11-23 | 
| Last Update Date | 2011-06-28 |