NPI | 1760299077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 10966) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 10966) |
Enumeration Date | 2024-12-11 |
Last Update Date | 2025-02-24 |