| NPI | 1659637544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A154654) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: IL 125061304) | |
| 207R00000X Internal Medicine (Licence: NM MD2015-0700) | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2026-06-19 |