| NPI | 1578945853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A159598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A159598) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: FL ME139232) | |
| 207R00000X Internal Medicine (Licence: HI MDN19389) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2026-03-17 |