| NPI | 1174660468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 044280) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR-44280) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-04-29 |