| NPI | 1427613793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 81575-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 81575-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2025-06-09 |