| NPI | 1669835039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 29199) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 66396) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0074670) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2026-06-22 |