| NPI | 1649779570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PR 024185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 024185) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2025-08-05 |