| NPI | 1952327173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY TP463)  | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: UT 9141045-1205)  | 
| Enumeration Date | 2006-07-14 | 
| Last Update Date | 2021-10-27 |