| NPI | 1518951839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO 2017005141) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 70762) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 34-00-3867-R) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 106048) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2023-03-07 |