| NPI | 1598732513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101235399) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD60890016) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 60489-20) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO 2023048377) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2026-02-11 |