| NPI | 1538629654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0102341) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX BP10079522) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-06-24 |