| NPI | 1316349038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 91748) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101275676) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 311119) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114404) | |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2022-10-29 |