| NPI | 1467609362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R6813) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 36569) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2008017832) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2021-10-18 |