| 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 |