| NPI | 1679959712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO 2021014856) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107411) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2021-08-17 |