| NPI | 1841789732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 2023-01364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 04542) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2023-11-29 |