| NPI | 1336343672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 35.125734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 37197) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2015-07-08 |