| NPI | 1538112347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 30876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD38104) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 30876) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-11-28 |