| NPI | 1841768256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME182188) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX BP10089916) | |
| 207R00000X Internal Medicine (Licence: FL TRN#33897) | |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2026-06-30 |