| NPI | 1639201650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 47223) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101240909) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2022-10-13 |