| NPI | 1629265079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 50465) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-53269) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2024-07-08 |