| NPI | 1366829731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PR 19952) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 32935) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-08-02 |