| NPI | 1225564610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL OS16082) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 059093930) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2022-07-07 |