| NPI | 1578551875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 2021-02512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 51100) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 51100) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2022-11-01 |