| NPI | 1578943841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 63388) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35.140500) |
| 207R00000X Internal Medicine (Licence: IL 125066553) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2021-09-02 |