| NPI | 1164872990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 71935-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-45807) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2025-07-23 |