| NPI | 1831629088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 1018302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 272601) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2024-06-24 |