| NPI | 1649230855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD060866L) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 33330) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-11-16 |