| NPI | 1457616419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD459715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201659) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2018-07-26 |