| NPI | 1659812915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A193734) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 73973) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2024-08-09 |