NPI | 1396481115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 45465) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10079886) |
Enumeration Date | 2022-05-05 |
Last Update Date | 2025-05-14 |