| NPI | 1902095730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G21537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G21537) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G21537) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2010-08-24 |