| NPI | 1396747721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME94328) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G23082) |
| 207R00000X Internal Medicine (Licence: CA G23082) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 2003-00713) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2025-10-08 |