| NPI | 1720308331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA 12732) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013480) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2024-10-24 |