| NPI | 1902241607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A142061) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 142061) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-07-02 |