| NPI | 1700089414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 64389-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 64389-20) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 64389-20) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2025-10-29 |