| NPI | 1326392291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO TL.0006908) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116025401) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2014014392) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2018-03-17 |