| NPI | 1821055963 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME 105168)  | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036-101490)  | 
| Enumeration Date | 2006-05-01 | 
| Last Update Date | 2023-12-26 |