| NPI | 1942556907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME152223) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VT 042.0013735) |
| 207R00000X Internal Medicine (Licence: FL ME152223) | |
| 207R00000X Internal Medicine (Licence: PA MT202655) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2021-11-02 |