| NPI | 1659766764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042-0015345) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 060-0004723) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-10-15 |