| NPI | 1528119591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 233915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224851) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2014-04-16 |