| NPI | 1376734962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME130998) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.203345) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 20601) | |
| 208D00000X General Practice (Licence: PR 20601) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2021-05-16 |