NPI | 1922487578 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA 20A17866) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV sl1101) |
Enumeration Date | 2015-05-28 |
Last Update Date | 2020-07-30 |