| NPI | 1730351529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD60462342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60462342) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OR MD28838) | |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2020-07-31 |