| NPI | 1447256326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101264377) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD042712L) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2018-06-27 |