| NPI | 1952419616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 159782) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 59935) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AK 180459) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 59935) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-10-17 |