| NPI | 1649327594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 066420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 40842) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 40842) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-10-05 |