| NPI | 1639606429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD d0098163) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 98492) | |
| 207R00000X Internal Medicine (Licence: RI MD17065) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-06-05 |