| NPI | 1902328826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: KY 57481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 57481) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2023-08-08 |