| NPI | 1235387358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDR.0000322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 51733) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2020-03-06 |