| NPI | 1174570378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 062559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 49164) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2009-07-09 |