| NPI | 1578658001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX F7711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX F7711) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-09-27 |