| NPI | 1326356411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 101128-875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271090) |
| 207R00000X Internal Medicine (Licence: IL 036.149032) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN15399) | |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2025-04-08 |