| NPI | 1326486465 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: SC 87142) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00499) | 
| Enumeration Date | 2013-06-11 | 
| Last Update Date | 2022-08-02 |