| NPI | 1295335461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 30583) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 207RG0100X) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2021-08-03 |