| NPI | 1336352772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 38798) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 27245) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104509) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 52288) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2015-05-06 |