| NPI | 1639367162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35-098338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY #390200000X) |
| 207R00000X Internal Medicine (Licence: OH 35-098338) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2015-03-26 |