| NPI | 1780797472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OR OR MD16978) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA WA MD00028081) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G 49148) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |