| NPI | 1699268581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 12236675-1204) |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: UT 12236675-1204) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2023-09-26 |