| NPI | 1306230362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX R6145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 19000) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: GA 96269) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-09-12 |