| NPI | 1568649135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 258312) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 258312) |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2021-02-04 |