| NPI | 1467899120 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AL 44093)  | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MS 27729)  | 
| Enumeration Date | 2013-06-03 | 
| Last Update Date | 2022-08-31 |