| NPI | 1639319049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 42303) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ H3577) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2015-07-09 |