| NPI | 1558821827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10081518) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX BP10081518) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2022-07-14 |