| NPI | 1790339471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MT 147819) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 83130-20) |
| 207R00000X Internal Medicine (Licence: IL 125.074091) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2024-12-18 |