| NPI | 1215139951 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 64266) | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AL 27817) | 
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MD D70299) | |
| Enumeration Date | 2007-06-04 | 
| Last Update Date | 2015-07-21 |