| NPI | 1285830778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35092959) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 56744-20) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.092959) | |
| 207R00000X Internal Medicine (Licence: WI 56744) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2016-07-18 |