| NPI | 1376502179 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: DC 036170) | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MD D0062361) | 
| Enumeration Date | 2006-03-21 | 
| Last Update Date | 2015-04-07 |