NPI | 1518329770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 20240137136) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 20240137136) |
207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME138983) | |
390200000X Student in an Organized Health Care Education/Training Program | |
207R00000X Internal Medicine (Licence: FL ME138983) | |
Enumeration Date | 2016-03-25 |
Last Update Date | 2025-09-17 |