| NPI | 1710188685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CT 044978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044978) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-06-18 |