| NPI | 1679709273 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 005862)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 005862)  | 
| 207R00000X Internal Medicine (Licence: AZ R1693)  | |
| Enumeration Date | 2009-06-09 | 
| Last Update Date | 2021-08-02 |