| NPI | 1609867902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 4364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 34364) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2011-11-04 |