| NPI | 1629164876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 38965) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: LA 025803) |
| 207R00000X Internal Medicine (Licence: LA 025803) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-03-15 |