| NPI | 1194163519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 4301514872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P28819) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2025-08-27 |