NPI | 1255855672 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MT233783) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN25714) |
Enumeration Date | 2017-07-27 |
Last Update Date | 2025-07-03 |