| NPI | 1639101926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PR 4852) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 4852) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-11-19 |