| NPI | 1962639823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 72981) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 072981) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-08-06 |