| NPI | 1891161162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: NV 22626) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: VA 0101260526) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2022-10-24 |