| NPI | 1528616984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 315586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT218650) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2024-06-14 |