| NPI | 1568683365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KS 04-35470) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME130792) |
| 207R00000X Internal Medicine (Licence: RI MD12239) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-03-11 |