| NPI | 1205868361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD3112) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: HI MD3112) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-10-25 |