| 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 |