| NPI | 1356706550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME134565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 055274) |
| 207R00000X Internal Medicine (Licence: FL ME134565) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2020-0357) | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2023-08-13 |