| NPI | 1720436843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301110432) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110432) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5315077284) | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2022-07-26 |