| NPI | 1508096470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 52150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58390) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2020-11-28 |