| NPI | 1700204021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 291664) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 291664) |
| 207R00000X Internal Medicine (Licence: LA 000000000000) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-12-20 |