| NPI | 1538692835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 71604) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 7287121) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-02-23 |