| NPI | 1033343736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301098443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098443) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 157067) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098443) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2015-07-09 |