| NPI | 1710214218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX Q5261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125056720) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2015-12-17 |