| NPI | 1669651881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301106886) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 48191) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.013847) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036126808) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: HI MD-20060) | |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2024-06-20 |