| NPI | 1518120161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 4301092347) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092347) |
| 207R00000X Internal Medicine (Licence: MI 4301092347) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2013-07-26 |