| NPI | 1700053824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101250139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101250139) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NV 18178) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2022-01-10 |