| NPI | 1235270224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY R1242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD32090) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2011-02-01 |