| NPI | 1396706867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MO R4231) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R4231) |
| 207R00000X Internal Medicine (Licence: MO R4231) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2012-03-28 |