| NPI | 1609308287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0074542) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S5906) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2025-06-09 |