| NPI | 1699862102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A39224) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A039224) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2019-08-20 |