| NPI | 1033666425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0116031985) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 77258) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2024-06-24 |