| NPI | 1881623395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 21960) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 21960) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-03-24 |