| NPI | 1215268362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: HI 14910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 14910) |
| 207R00000X Internal Medicine (Licence: NY 255926) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A111967) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 255926) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2021-12-08 |