| NPI | 1184009631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 60328) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 63349) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 74717) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2025-06-09 |