| NPI | 1427362698 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 72367)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA09787900)  | |
| Enumeration Date | 2010-07-30 | 
| Last Update Date | 2022-11-14 |