| NPI | 1205829272 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 6425) | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NH 6425) | 
| 174400000X Specialist (Licence: NH 6425) | |
| Enumeration Date | 2005-08-25 | 
| Last Update Date | 2022-04-19 |