| NPI | 1811979925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 281691) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME92296) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2021-05-26 |