| NPI | 1932176765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101039755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101039755) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101039755) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2015-06-16 |