| NPI | 1336272707 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MD D95140)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL 27396)  | 
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036124457)  | |
| Enumeration Date | 2007-03-14 | 
| Last Update Date | 2024-02-02 |