| NPI | 1386930667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 7629) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102206419) |
| 208M00000X Hospitalist (Licence: IN 02004549A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125060442) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2020-11-17 |