| NPI | 1376992446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD473140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8400) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ 7248941) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2021-06-28 |