| NPI | 1770526212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: MS 13236) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 13236) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MS 13236) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2025-01-30 |