| NPI | 1447514302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA OP60945227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02004673A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11016698A) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2019-09-03 |