| NPI | 1629413323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 19633) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 32,474-R) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: PR 31709-R) | |
| 207R00000X Internal Medicine (Licence: PR 31047-R) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2024-06-06 |