| NPI | 1841346152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: DC MD038324) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 125680) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: DC MD038324) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 125680) | |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2020-01-16 |