| NPI | 1295887040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL OS9591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS9591) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: SC 1056) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-05-02 |