| NPI | 1164719530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME135489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 270187) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 270187) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2018-07-11 |