| NPI | 1538376777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60234885) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096338) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301096338) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017320) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-06-17 |