| NPI | 1184112856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AL L.5314SP) |
| Additional Taxonomies | 207RI0008X Internal Medicine Hepatology (Licence: MA 275246) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 275426) | |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2020-08-28 |