| NPI | 1720063761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 77160) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35 10 0088C) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35-100088) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2024-07-16 |