| NPI | 1861551491 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD00049135)  | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A73347)  | 
| Enumeration Date | 2006-12-08 | 
| Last Update Date | 2008-03-12 |