| NPI | 1003801390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CA C42486) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C42486) |
| 208000000X Pediatrics (Licence: CA C42486) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2023-02-06 |