| NPI | 1003235540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A168030) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD045237) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 | 
| Last Update Date | 2020-12-10 |