| NPI | 1356327746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 31390) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 19845) |
| 208D00000X General Practice (Licence: MN 31390) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2022-01-12 |