| NPI | 1942286802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 36451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 36451) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 28199) | |
| 208D00000X General Practice (Licence: MN 36451) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-11 |