| NPI | 1194936757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME147148) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 096715) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104577) | |
| 207RI0008X Internal Medicine, Hepatology (Licence: OH 096715) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: PR 15391) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 52354) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-02-05 |