| NPI | 1710349873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 202200243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 82950) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2022-06-28 |