| NPI | 1215978234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: UT 7573790-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 13849) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WV 13849) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2013-02-15 |