| NPI | 1518130624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NE 31417) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 04-38815) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 50252) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2019-02-19 |