| NPI | 1528295656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 58928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2009007974) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IA MD-45227) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2024-07-17 |