| NPI | 1023347770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T0628) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 67649) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2021-06-03 |