| NPI | 1790871713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 49132) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 49132) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-13 |