| NPI | 1386871598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T3831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194941) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101257552) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-09-30 |