| NPI | 1417245143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CO 0057701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6583) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2017-01-26 |