| NPI | 1144432444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 62978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH NONE) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 42501) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2014-09-30 |