| NPI | 1558708123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 96695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 255361) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP05175) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2023-12-14 |