| NPI | 1881670867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 40028) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 40028) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-14 |