| NPI | 1760646202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 54707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 54707) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2016-03-24 |