| NPI | 1235390626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD 603465) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 242529) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-03-02 |