| NPI | 1003856188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G45569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G45569) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2026-05-18 |