| NPI | 1649616301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101270278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301109577) |
| 207R00000X Internal Medicine (Licence: VA 0101270278) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A165838) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-04-01 |