| NPI | 1174506380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G69040) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CA G69040) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-04-11 |