| NPI | 1215934286 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 022725) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 52691) | 
| 207R00000X Internal Medicine (Licence: FL ME54648) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 52691) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME54648) | |
| 207R00000X Internal Medicine (Licence: CT 022725) | |
| Enumeration Date | 2005-07-05 | 
| Last Update Date | 2009-03-30 |