NPI | 1265788574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 68415) |
Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 59201) |
2080P0205X Pediatrics, Pediatric Endocrinology (Licence: WI 68413) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-07-24 |
Last Update Date | 2025-04-17 |