| NPI | 1538573555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: OH 35.136519) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: NC 2017-00220) |
| 207R00000X Internal Medicine (Licence: MI 4301105386) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-07-21 |