| NPI | 1649282674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 62806) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G55799) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G55799) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-11-22 |