NPI | 1194886119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G36288) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G36288) |
208100000X Physical Medicine & Rehabilitation (Licence: CA G36288) | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2012-02-23 |