| NPI | 1588733109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101239018) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239018) | 
| Enumeration Date | 2006-11-07 | 
| Last Update Date | 2010-05-13 |