| NPI | 1487912697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD207996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 141499) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2024-05-28 |