| NPI | 1235692138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY FS5466239) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T1591) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2026-08-31 |