| NPI | 1881656106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: UT 167054-1205) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: UT 167054-1205) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2025-07-01 |