| NPI | 1154062446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0116037085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS22686) |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2026-07-03 |