| NPI | 1841352739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL Me49240) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME49240) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2010-03-03 |