| NPI | 1699711341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME26500) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME0026500) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2026-03-06 |