| NPI | 1366013815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-53055) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2024-07-05 |