| NPI | 1720234297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL OS13543) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX N/A- temporary licen) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2015-10-05 |