| NPI | 1265019426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KS 04-53133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-01677) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2026-06-30 |