| NPI | 1659660272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 81162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD044169) |
| 207R00000X Internal Medicine (Licence: GA 81162) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: SC 84938) | |
| 207R00000X Internal Medicine (Licence: FL ME119677) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2024-02-19 |