| NPI | 1487084802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35.146151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 186686) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2022-12-12 |