| NPI | 1356436562 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101049471) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D42513) | 
| Enumeration Date | 2006-10-04 | 
| Last Update Date | 2025-09-11 |