| NPI | 1922502921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: OH 35.150934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301504592) |
| 207R00000X Internal Medicine (Licence: OH 35.150934) | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: IN 01087565A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-07-11 |