| NPI | 1770567786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IA 22598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 22598) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IA 22598) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2025-09-11 |