| NPI | 1255781274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KS 0444749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016019076) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2021-07-21 |