| NPI | 1861757346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD70006622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018006614) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO 2018006614) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2025-08-03 |