| NPI | 1538286687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301087860) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087860) |
| 207R00000X Internal Medicine (Licence: MI 4301087860) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2014-09-17 |