| 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 |