| NPI | 1003086778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX U2019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME115779) |
| 207R00000X Internal Medicine (Licence: TX U2019) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-03-09 |
| Last Update Date | 2023-09-18 |