| NPI | 1215168760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S4625) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 303291) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11014749A) | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2022-11-11 |