| NPI | 1467196535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2023043760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023043760) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2025-06-02 |