| NPI | 1942626767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA 20A13210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A13210) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2018-01-10 |