| NPI | 1225054109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: MO 2008009810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 3718) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-06-04 |