| NPI | 1194142166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CO DR.0065551) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA OS018709) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2023-06-06 |