| NPI | 1083672133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 172612) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A50277) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA04949500) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2019-05-10 |