| NPI | 1659690956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME117192) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN14763) |
| 207R00000X Internal Medicine (Licence: FL ME117192) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2019-08-05 |