| NPI | 1841346152 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: DC MD038324) | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 125680) | 
| 261QM2500X Clinic/Center, Medical Specialty (Licence: DC MD038324) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 125680) | |
| Enumeration Date | 2007-01-27 | 
| Last Update Date | 2025-04-24 |