| NPI | 1790007359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301072095) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A30437) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 4301072095) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A30437) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301072095) | |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2011-04-25 |