| NPI | 1093736522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD02000E) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ MA47641) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2012-05-18 |