| NPI | 1154784783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 151128) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 11265647-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2022-08-12 |