| NPI | 1033666425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 23273)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 77258)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: VA 0116031985)  | |
| Enumeration Date | 2016-09-02 | 
| Last Update Date | 2024-12-05 |