| NPI | 1467012278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CT 77358) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT019355) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-08-09 |