| NPI | 1790776409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME96956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0058302) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MD D0058302) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2014-09-23 |