| NPI | 1700131844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: UT 9876842-1205) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 57.025738) |
| 207R00000X Internal Medicine (Licence: MA 252611) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-05-30 |