| NPI | 1255328738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO 2009036449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC SC27767) |
| 207R00000X Internal Medicine (Licence: MO 2009036449) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 41721) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2021-02-01 |