| NPI | 1609994490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301085781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085781) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MA 237003) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: VT 042-0012216) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085781) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2015-06-18 |