| NPI | 1962572644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: DC 11580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 11580) |
| 207U00000X Nuclear Medicine (Licence: DC 11580) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2023-11-28 |