| NPI | 1841859717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 75732) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 75732) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-07-19 |