| NPI | 1437444007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T9044) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD044027) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.126515) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 3211) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2023-01-12 |