| NPI | 1447505953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101275096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.020836) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 64122 - 20) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2023-12-15 |