| NPI | 1811927270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 108930) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 108930) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-06-15 |