| NPI | 1528175072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 21493) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 21493) |
| 207U00000X Nuclear Medicine (Licence: AZ 21493) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |