| NPI | 1629131958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: NY 198066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 198066) |
| 207RA0000X Internal Medicine Adolescent Medicine (Licence: NY 198066) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-09-06 |