| NPI | 1861602518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD60410194) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7565) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IA 39159) | |
| 207R00000X Internal Medicine (Licence: IA 39159) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-10-08 |