| NPI | 1629281852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MD D18146) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MD D18146) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-01-14 |