| NPI | 1790216406 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A171659) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 282217) | 
| Enumeration Date | 2017-03-23 | 
| Last Update Date | 2023-08-07 |