| NPI | 1407207301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.147534) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NM RS2018-0158) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: KS 9409042) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-06-06 |