| NPI | 1164674644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A106801) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 12784) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2021-12-21 |