| NPI | 1275747891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101257190) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35097654) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301095243) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-11-10 |