| NPI | 1386694966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX M0305) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M0305) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2022-11-11 |