| NPI | 1649546623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: IA MD-48522) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A128296) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2021-08-13 |