| NPI | 1972600880 |
|---|---|
| Professional Name | EASTSIDE DIABETES CLINIC |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA a33652) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-10-18 |