| NPI | 1114471489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 21028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2022-0261) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2022-0261) | |
| 208D00000X General Practice (Licence: PR 21028) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2023-08-21 |