| NPI | 1780769109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IA 38083) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 242183) |
| 207R00000X Internal Medicine (Licence: IN 01062597A) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-10-14 |