| NPI | 1003251497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 27717) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 27717) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10047494) | |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2020-11-16 |