| NPI | 1407101975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CO DR.0055484) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 55484) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 5101023536) | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2018-06-27 |