| NPI | 1902041197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: SD 8961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN-10869) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 105575) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 54495) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2014-06-11 |