| NPI | 1952747966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 2019-00588) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102645) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102645) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2021-09-22 |