| NPI | 1518167295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35.126326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085303) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-01-14 |