| NPI | 1205275161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301504577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 17199) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD P29238) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-05-18 |