| NPI | 1902987357 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301046910) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301046910) | 
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 4301046910) | |
| Enumeration Date | 2006-10-18 | 
| Last Update Date | 2022-05-19 |