| NPI | 1013168392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60319422) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX TMB PIT# BP10031000) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2013-07-24 |